On January 15, ISASS was a signatory to a letter to CMS in response to a Request for Information issued by CMS after the White House Executive Order issued on Oct. 3, 2019. In that Executive Order, President Trump issued an Executive Order on “Protecting and Improving Medicare for our Nation’s Seniors.” While the Executive Order does not provide legislative or regulatory specifications, it raises policy areas that the President believes need to be addressed to improve the Medicare program.
The Executive Order aims to expand enrollment in Medicare Advantage (MA) plans to make them more attractive to seniors than the traditional fee-for-service program. Within one year, the Secretary of Health and Human Services is asked to propose regulations and implement other administrative actions to provide more diverse and affordable MA options for seniors, by:
- Encouraging innovative MA benefit structures and plan designs, including better use of MSAs by seniors.
- Including a payment model that allows MA beneficiaries to share more directly in program savings.
- Ensuring that fee-for-service Medicare is not promoted over MA.
- Issuing a report within 180 days that identifies approaches to modifying Medicare fee-for-service payments to more closely reflect prices paid in MA and commercial insurance markets.
- Adjusting network adequacy requirements, including potentially greater use of telemedicine services.
- Proposing reforms to Medicare to allow providers to spend more time with patients, addressing areas such as conditions of participation, supervision requirements, licensure requirements, addressing disparities in reimbursement between physicians and non-physicians, and other issues.
- Streamlining the approval, coverage, and coding process so that innovative products are brought to market faster.
- Ensuring that Medicare payments and policies encourage competition and a diversity of sites for patients to access care (site neutrality).
- Studying the use of various alternative payment and competitive bidding approaches, including use of MA-negotiated rates to set fee-for-service rates.
The letter from ISASS and other stakeholders focused on the part of the Executive Order calling for the expansion of privileges for non-physician practitioners. ISASS and other physician specialty societies were concerned about the impact of this part of the order on patient care, and the specialty society letter calls on the White House and HHS to prioritize the physician/patient relationship as critical to quality patient care.
Read the Executive Order here.
Read the Specialty Society letter.